替比夫定与恩替卡韦治疗HBeAg阳性CHB对比研究

目的观察替比夫定与恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者的临床疗效及安全性。方法将48例慢性乙型肝炎患者随机分为替比夫定组25例,恩替卡韦组23例,疗程均为72周。观察两组治疗4,12,24,48,72周时ALT复常率、HBV DNA低于检测下限值率、HBeAg血清学转换率及药物的安全性。结果治疗4,12,24,48,72周时ALT复常率、HBV DNA转阴率两组比较差异均无统计学意义(均P>0.05);治疗4,12,24周时HBeAg血清学转换率两组比较差异均无统计学意义(均P>0.05);治疗48周及72周时两组HBeAg血清学转换率分别为36.0%、40.0%和8.7%、13.0%,两组比较差异均有统计学意义(均P<0.05)。两组均未发现明显不良反应。结论替比夫定与恩替卡韦治疗HBeAg阳性慢性乙型肝炎均具有强效抗病毒作用,近期ALT复常率、HBV DNA阴转率均无明显差异,但治疗48,72周时替比夫定组HBeAg血清学转换率高于恩替卡韦组。两药治疗的安全性和耐受性良好。

Comparative Study of Telbivudine and Entecavir in the Treatment of Patients with HBeAg-Positive Chronic Hepatitis B

Objective To evaluate the efficacy and safety of telbivudine versus those of entecavir for patients with HBeAg-positive chronic hepatitis B.Methods 48 patients were randomized to receive telbivudine(25 patients) or entecavir(23 patients) for 72 weeks.Serum ALT normalization rate,rate of undetectable HBVDNA,HBeAg seroconversion rate,and safty of the two agents were determined at weeks 4,12,24,48,and 72.Results Serum ALT normalization rate and rate of undetectable HBVDNA did not differ significantly between the two groups at weeks 4,12,24,48,and 72(P>0.05),nor HBeAg seroconversion rate at weeks 4,12,and 24(P>0.05).HBeAg seroconversion rates was 36.0% in telbivudine group and 8.7% in entecavir group at week 48(P<0.05),40.0% and 13.0% at week 72(P<0.05).No adverse reactions were found in both groups.Conclusion Both telbivudine and entecavir had a strong antiviral effect on HBeAg-positive chronic hepatitis B.Serum ALT normalization rate,and rate of undetectable HBVDNA did not differ between the patients receiving telbivudine and those receiving entecavir,but telbivudine had a higher rate of HBeAg scroconvcrsion than entccavir at weeks 48 and 72.Both medications had good safty and tolerance.